Iowa City Choir Helps Parkinson’s Patients Find Their Voice

Lloyd Bonifas used to play fiddle and sing lead in a Bellevue, Iowa-based country dance band called Radio Flyer. Then 11 years ago, at age 56, he was diagnosed with Parkinson’s disease—a neurodegenerative disorder that affects movement and speech. Lloyd’s wife, Mary Jo, says his strong voice was “something Parkinson’s took away.”

Now, the Bonifases sing again beside Abbey Dvorak (04MA, 11PhD), an associate professor at the University of Iowa School of Music who introduced them to Tremble Clefs, a community choir that provides music therapy to people with Parkinson’s disease and their caregivers. The couple drives about two hours every week to rehearsal at the Iowa City Senior Center.

At the group’s biannual concert this past winter, the Bonifases shared their story and introduced a new verse to the choir’s rendition of “This Land is Your Land” that Lloyd wrote to represent the state of Iowa. Says Mary Jo about the Tremble Clefs’ impact on Lloyd: “For the first time in many years, I heard his lovely voice again.”

Sun Joo Lee, the founder and director of the Tremble Clefs choir in Iowa City, understands the healing power of music. A board-certified music therapist and UI doctoral candidate in music therapy, Lee originally aspired to become an opera singer but would experience stomach or back pain whenever she’d perform. Her mother suggested she take music therapy classes to learn how to manage her symptoms. She said learning about music therapy changed her life—and inspired her to help others do the same.

“This group has become my family.” —Sun Joo Lee

While a voice performance and music therapy master’s student at Arizona State University, Lee first heard about Tremble Clefs, which began in 1994 in Scottsdale, Arizona. In 2008, she started a Sun City, Arizona, branch and later became director of the Scottsdale choir. Tremble Clefs has since expanded to become a nonprofit organization with groups across Arizona and California.

In October 2023, Lee founded the Tremble Clefs choir in Iowa City after Dvorak recruited her to join the UI’s music therapy program. The group sings show tunes such as “Oh, What a Beautiful Mornin’,” folk songs like “Yankee Doodle,” and classic pop hits that include “Can’t Help Falling in Love” to uplift spirits and encourage audience participation. The goal is not to teach singing, Lee says, but to use singing, music-assisted movement, and breathing-related exercises to help Parkinson’s patients maintain their motor and speech skills. It also builds self-esteem and provides opportunities for patients and their families to stay active, socialize, and find support.

 “Because of their voice difficulties, [many Parkinson’s patients] become socially withdrawn,” says Lee. “They decide not to use their voice for communication, which is a big problem that can significantly reduce their quality of life, so I just keep trying to provide different ways to inspire and encourage them to stay committed to therapy.”

PHOTO: Seth Diehl University of Iowa music therapy doctoral candidate Sun Joo Lee leads the Iowa City Tremble Clefs choir in one of its public concerts that encourages audience participation.

The Iowa City choir—which has around 20 members—doubles as a practicum for music therapy students, who work alongside Lee and Dvorak to serve participants. Lee hired a pianist through a grant from the UI Office of Engagement’s Graduate Engagement Corps and also earned funding to support Tremble Clefs after receiving honorable mention in the Graduate College’s annual Three Minute Thesis research-sharing competition.

When opera singer Renée Fleming came to Hancher last semester, Lee and Dvorak were among a select group of UI researchers who spoke on a panel about the intersection between music and the mind. At the event, Lee shared that she’s used music therapy to help people with a range of health conditions, including launching the Shine Your Light Choir in Phoenix with the Banner Alzheimer’s Institute for people with memory loss and a UI REACH choir called Heavenly Hawkeyes for students with intellectual, cognitive, and learning disabilities.

Following her graduation from Iowa this spring, Lee plans to join the faculty at the University of Missouri-Kansas City and start a new Tremble Clefs branch this fall. The Iowa City choir will find a new director. Lee calls the move “bittersweet” after building meaningful relationships over the years with choir members, whether through celebrating their treatment progress or singing songs of comfort at their deathbed.

“For me as a music therapist, Tremble Clefs is not just a group of people I get to meet through my career,” she says. “This group has become my family.”